| NPI | 1710260575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA Rph 021966) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS037359) |
| Enumeration Date | 2011-09-27 |
| Last Update Date | 2011-09-27 |